LGI-1脑炎发作性症状的临床特征及脑电图表现  

Clinical features and electroencephalographic manifestations of episodic symptoms of LGI-1 encephalitis

作　　者：胡奇晟 吕飞燕 汪汉芳 陈若梦 刘虎 张克加 郝江慧 贾丽景[1] 王维平[1] HU Qisheng;LV Feiyan;WANG Hanfang(Department of Neurology,the Second Hospital of Hebei Medical University,Shijiazhuang(050000),Hebei,China)

机构地区：[1]河北医科大学第二医院神经内科,河北石家庄050000

出　　处：《癫痫与神经电生理学杂志》2022年第2期96-103,共8页Journal of Epileptology and Electroneurophysiology(China)

基　　金：河北省教育厅专业学位教学案例库建设项目(KCJSZ2021046)。

摘　　要：目的探讨LGI-1脑炎发作性症状的临床及脑电图表现,以期寻找该病具有标志物意义的临床及脑电图特征。方法回顾性分析2020年5月至2021年11月河北医科大学第二医院神经内科收治的12例LGI-1脑炎患者的病例资料。分析其临床特征、视频脑电图及影像学资料等。结果12例患者中,长程视频脑电图记录到104次发作,有8例患者记录到52次面臂肌张力障碍发作(FBDS),其中24次(46%)脑电图伴有电压下降,后出现低波幅快节律、节律性δ活动或弥漫性棘慢波。不伴有FBDS的发作期脑电图主要表现为中、高波幅θ或δ波,其中可夹杂尖波发放。结论LGI-1脑炎的发作性症状常表现为FBDS,多种运动症状、感觉和自主神经症状及以上症状的不同组合。广泛性电压降低可能是LGI-1脑炎发作性症状脑电图演变的重要组成部分。Objective To investigate clinical features and electroencephalographic(EEG)manifestations of episodic symptoms of LGI-1 encephalitis to find the clinical features and EEG manifestations as the markers for the disease.Methods The clinical features of 12 patients with LGI-1 encephalitis in the Department of Neurology,the Second Hospital of Hebei Medical University from May 2020 to November 2021 were retrospectively analyzed.Their clinical features,EEG Videos and imaging data were analyzed.Results Among 12 patients,long-term EEG videos recorded 104 episodes,and 52 episodes of faciobrachial dystonic seizures(FBDS)were seen in 8 patients.Among 52 episodes of FBDS,24 episodes(24/52,46%)were accompanied by voltage drop,followed by low amplitude fast rhythms,rhythmicδactivity or diffuse spike and slow waves.The episodic EEG without FBDS mainly exhibited medium-high amplitudeθorδwaves,which may be mixed with spikes.Conclusion Episodic symptoms of LGI-1 encephalitis often exhibit FBDS,multiple motor symptoms,sensory and autonomic nerve symptoms and various combinations of the above symptoms.Generalized voltage reduction may be an important component of the EEG evolution of episodic symptoms of LGI-1 encephalitis.

关 键 词：LGI-1 自身免疫性脑炎 癫痫 痫性发作 面臂肌张力障碍发作(FBDS) 脑电图 

分 类 号：R512.3[医药卫生—内科学] R741.044[医药卫生—临床医学]